Background: There is a wide consensus on the fact that surgical treatment of incidental gallbladder carcinoma should be based according to T stage: while simple cholecystectomy is considered an adequate treatment for confined carcinomas to the lamina propria (T1a), it is still being discussed in the case of cancer limited to muscularis mucosae (T1b), and a secondary extended resection is the only curative option for tumors invading the perimuscolar connective tissue (T2), and seems to improve survival in selected advanced cases. However, it is still not clear which subset of patients is really suitable for aggressive reoperations, and their effective impact on the prognosis of incidental neoplasm. The purpose of this study is to evaluate these aspects in a retrospective review of gallbladder carcinomas diagnosed during or after 9284 cholecystectomies performed with a benign indication.